Provider Demographics
NPI:1649752734
Name:ANCIRA, ASHLEY AILEEN
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:AILEEN
Last Name:ANCIRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 UGARTE ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-4062
Mailing Address - Country:US
Mailing Address - Phone:956-774-2630
Mailing Address - Fax:
Practice Address - Street 1:619 E CALTON RD # 3
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3689
Practice Address - Country:US
Practice Address - Phone:956-722-3377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-05
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX406952355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant